LAST FOUR WEEKS IN REVIEW

Working on health care wins for the middle class

The middle class needs a win: Skyrocketing health premiums are squeezing the middle class. They need a win on health care – which is why I stood with other Democrats in holding the line on funding the federal government absent a deal to lower prices. For over a month, President Trump has refused to come to the negotiating table, so I went to his television screen. On Fox News, I addressed the president directly, demanding that he work with Democrats to reach a health care deal that both parties can support:

• Extend the ACA premium support for the middle class for at least one year.

• Fund patients directly through medical spending accounts like ICHRAs and HSAs.

• Support doctors & nurses by tripling the number of community health clinics, creating a ‘public option for primary care.'

Out-of-pocket caps for prescription drugs: In addition to seeking a deal on the ACA, I also introduced legislation to lower prescription drug co-pays for ACA beneficiaries. Insurance doesn’t work if the co-pays and deductibles are unaffordable. When people pay premiums to insurance companies, they should be able to trust that the insurer will cover them when a doctor prescribes a drug they need. That is why I introduced the ACA Copay Cost and Affordability for Patients (CAP) Act to limit annual prescription drug cost-sharing for patients enrolled in health insurance plans through the ACA Marketplaces. 

The ACA Copay CAP Act would:

Establish new out-of-pocket caps for prescription drugs:

• Starting in 2027, self-only coverage on the ACA would include a $2,000 cap per year for prescription drugs.

• Starting in 2027, family coverage on the ACA would include a $4,000 cap per year for prescription drugs.

New realities for health care: XRHealth is a Needham company using virtual-reality headsets to deliver cognitive and physical therapy to veterans and other patients. I visited with Massachusetts's Secretary of Veterans' Services Jon Santiago to learn more and try it myself. It's an example of how technology might lower prices and improve quality in health care, since one clinician can deliver personalized, remote therapy to many patients at once.

One SouthCoast Chamber of Commerce: Congressman Bill Keating and I spoke to the One SouthCoast Chamber of Commerce in Westport. We shared ideas to lower health care premiums; and reinforced the importance of the rule of law for a positive business climate. Health insurance premiums are a particular problem for business owners throughout Massachusetts, who are facing double-digit increases.

I support policies that divorce coverage from employment, particularly in small-and medium-sized enterprises, through approaches that shift beneficiaries from employer-sponsored insurance to Medicaid and the ACA exchanges. Insurance works best with big, diverse risk pools; thin layers of administration with long-term outlooks; and coverage for events that are rare, unpredictable, and expensive. Medicaid and the ACA are well-positioned to offer this type of coverage at lower cost than the status quo of small-group plans, but it will require challenging the status quo on both sides of the left-to-right debate.

Confronting grift and quackery in RFK Jr.’s department

RFK Jr.’s corrupt inner circle: RFK Jr. has been closely advised by Calley Means, who for the better part of this year served as White House advisor to the HHS secretary and publicly touted his role as a leading policymaker behind the Trump administration’s ‘Make America Healthy Again’ (MAHA) initiative. He operated as a special government employee (SGE) to avoid ethics requirements that would have compelled him to disclose the extent of his financial interests in his company, True Medicine Inc. (TrueMed).

This company profits from the MAHA policy agenda that Means is implementing.

On October 30, Means announced he had left his role as an SGE, only to reappear three weeks later as a permanent HHS advisor. Citing a letter I sent along with Senator Adam Schiff (D-CA) to RFK Jr. demanding the release of Means’ financial disclosure forms, a White House spokesperson shared that Means will, now, divest his holdings in TrueMed. 

I will continue to pursue vigorous oversight over Means to ensure that he does in fact divest, and I will continue to battle RFK Jr. and his hangers-on as they undermine science in pursuit of grift.

Favoritism over facts at the FDA: For months, I’ve warned that the Commissioner’s National Priority Voucher (CNPV) program at the FDA would accelerate drug and biologic approvals not for the most promising science, but for companies most closely aligned with MAGA. In September, I sent a letter to Commissioner Makary outlining my concerns about the program’s potential for abuse and requesting details on what safeguards were being put in place to protect scientific integrity.

Since then, my office has received no response from the FDA. However, the implementation of the CNPV program has sparked internal conflict among senior FDA officials, who have raised the same concerns I have. Most recently, Dr. Richard Pazdur, the director of the FDA’s Center for Drug Evaluation and Research, sounded the alarm that the program lacked transparency, threatened public health, and may be illegal. 

I sent a new letter on November 20, reiterating my earlier questions on the basis that “the FDA must continue to operate on the basis of science alone and should not be involved in pricing or any other political directives of the Trump Administration… It is antithetical to the FDA's statutory mission to promote and protect public health by ensuring that drugs, biologics, medical devices, and other products are safe, effective, and properly labeled.”

The CNPV program is yet another example of MAGA’s crony capitalism that undermines fairness in medical science and discovery. It is encouraging that FDA senior staff are voicing their concerns, and I will continue to ally with scientists at the agency who are pursuing their mission of safety and efficacy with integrity.

Vaccines save lives: I cosponsored H.Res. 848, which affirms the United States’ continued support for the purchase of vaccines for low-income countries through Gavi, the Vaccine Alliance. Since 2000, Gavi has helped immunize over 760 million children in some of the world's most disadvantaged countries. This resolution calls for increased commitment and investment by the United States for the 2026 to 2030 strategic period to allow Gavi to maximize its impact and leverage contributions from other countries and donors.

In addition to supporting Gavi, this resolution also encourages the continued use of State Department and Centers for Disease Control and Prevention (CDC) resources to strengthen local public health capacity for new and underutilized vaccines. 

 Launching the Kids Online Safety Caucus 

Meta downplayed risks to children: I joined Boston Public Radio to discuss how, in Congress, I’m leading the fight against Meta and Big Social for attention-fracking our children and hooking the American public on digital dopamine. Just how reckless are these social media giants? 

Last week, TIME’s Charlotte Alter reported on an unsealed court filing, detailing Instagram’s former head of safety and well-being Vaishnavi Jayakumar’s testimony that she was “shocked to learn the company allowed a ‘17x’ strike policy for accounts reportedly involved in the trafficking of humans for sex” when she joined Meta in 2020.

Accounts were allowed to be involved in sex trafficking 16 times before Meta considered it a problem. 

In addition, Charlotte reported that “Meta was aware that millions of adult strangers were contacting minors on its sites; that its products exacerbated mental health issues in teens; and that content related to eating disorders, suicide, and child sexual abuse was frequently detected, yet rarely removed.” This follows Meta’s internal documentation that said it was “appropriate for 12-year-olds to have ‘sensual’ conversations with chatbots.” 

These companies rank among the most pernicious in modern history. I hear from parents all over the MA-04 that they feel powerless against the tech executives who get richer each minute their child spends staring at a screen. As a member of the congressional committee with jurisdiction over social media, I am resolved to give these parents back their power. That is why last week, I launched the Bipartisan Kids Online Safety Caucus with Representative Erin Houchin (R-IN) to bring together lawmakers, parents, educators, and experts to share information and propose practical policies that protect children online. Rep Houchin and I have already put forward legislation on chatbots’ interactions with children.

Should Congress more heavily regulate the nation’s largest social media corporations like Meta, Snap, and TikTok?

Phone-free schools: Massachusetts must catch up to other states on phone-free schools. Principals and superintendents from the MA-4 joined my Zoom Q&A session on the evidence and law behind banning phones, bell to bell, with Dr. Jhilam Biswas, president of the Massachusetts Psychiatric Society, and Attorney Liza Hirsch, director of the Children’s Justice Unit at the Massachusetts Attorney General’s Office. 

We discussed my federal work to hold social media corporations accountable for treating children like products; pending state legislation to keep phones out of classrooms; and the latest cognitive research supporting many educators', parents', and students' intuition: the economy of endless scrolling can be profoundly harmful to developing brains. The superintendents and principals also shared with one another their experience in regulating phone use at the school level, with recommendations for both policy and research that would be helpful.

Using American power for good in Ukraine, Venezuela, and the West Bank

Peace negotiations for Ukraine: Ukraine and its European allies should take President Trump’s peace proposal seriously, not literally. Drop the terrible terms (e.g. 6–8, 21, 25–27), which are insulting military and territorial concessions, and build off the provisions that could achieve a secure eastern border, freedom of navigation in the Black Sea, and accession to the European Union, which I have long proposed as the definition of victory. The Ukrainian people should be empowered to support a final deal via a referendum.

American Coalition for Ukraine: I met with constituents from the American Coalition for Ukraine in Washington to discuss the ongoing negotiations for peace. I continue to be a strong supporter of Ukraine, including (1) using frozen Russian assets to fund Ukraine's defense, (2) authorizing Ukrainian strikes against Russian oil refineries and critical infrastructure, and (3) sanctioning Russian oil exports. I have advocated these priorities with both the Biden and Trump administrations and will continue to press for strength as the best posture for peace in negotiations with the Kremlin.

No illegal and misguided war in Venezuela: As a Marine officer, I led a special operations mission that trained Panamanian Public Forces in drug interdiction tactics. We worked with our Colombian allies. Success in Latin America requires this kind of partnership, whether military, economic, or diplomatic. It is not achieved by parking an aircraft carrier off the coast of Venezuela, giving its dictator the villain-narrative he wants to continue his crackdown on democracy and economic freedom.

I co-sponsored the No Unauthorized Force in Venezuela Act to prohibit the executive branch from spending any federal funds on the use of military force inside Venezuela or against Venezuelan forces, including remote or intermittent strikes, unless Congress passes a specific Authorization for the Use of Military Force (AUMF). Congress must act to take back its war powers from an out-of-control president. And President Trump must stop abusing the military to distract from his economic mismanagement.

Demolition of Umm Al-Kheir: I joined 104 Members of Congress in a letter urging Israeli Prime Minister Benjamin Netanyahu to immediately halt plans to demolish buildings, including private homes and a community center, in the West Bank village of Umm Al-Kheir. The Israeli government’s demolition orders follow repeated instances of settler violence against the village, including the killing of 31-year-old community leader and peace activist Awdah Hathaleen earlier this year.

In our letter, we stated that: “Attempts by settlers, vigilantes, or the government to destroy the village of Umm Al-Kheir will traumatize this peaceful community and jeopardize the prospects for long-term peace, mutual security, and self-determination for Israelis and Palestinians at this critical moment.”

A future built, not bought: New Bedford's port was the EPA's first maritime Superfund cleanup. Today, it's a beehive of industry: fishing, offshore wind, and marine technology, such as autonomous vessels. I traveled to New Bedford for remarks at Blue Water Autonomy's unveiling of its 145-ton, ship-scale autonomous test vessel. I pointed to the need for maritime drones in the Pacific to counter Chinese belligerence, both as pre-deployed logistics assets and as force projection enablers.

Afterwards, New Bedford Mayor Jon Mitchell and Port Authority Director Gordon Carr gave me a tour of the harbor, during which I learned about the port's history, its role as an economic engine for South Coast New England, and the resources it needs for the future.

The winning formula for Massachusetts in New Bedford and across our state is: deep R&D + patient capital + precision manufacturing. Re-industrializing America will require solving the hardest problems at the intersection of bits & atoms, and Bay Staters do that exceptionally well. Trump Inc. wants a future that can be bought with crony capitalism, but the future must be built, not bought.

Trump’s tariffs are hurting Fall River businesses: I visited one big company and one small one in Fall River. First was the Whirlpool Corporation, which manufactures commercial laundry equipment here. Our second visit was to Atlantic Trading, an import-export firm that specializes in trade between the United States and Cape Verde. I spoke with the employees and entrepreneurs behind both to learn about their careers and stories, from the manufacturing of dryers to shipping rice and cars across the Atlantic.

While the companies are different, both create good jobs in Fall River, and both are subject to the whiplash of this administration's tariff policy, which is raising prices and reducing investment. I support free trade with free people and a business climate that benefits from low-cost energy, the rule of law, and expanding markets.

Immigration brings innovation: The Mansfield Bio-Incubator, which leases co-working space to startups, hosted a pitch competition. Many, if not most, of these scientific entrepreneurs were immigrants, and I started with a simple message: Thank you for building here; you are welcome in Massachusetts; and do not let anyone make you feel less than fully American. 

Our nation is not based on blood and soil but rather on the ideas of freedom, natural rights, and equality. Immigrants have been bringing these ideas to life in the Commonwealth for 400 years.

Working above the API: MIT invited me to help launch the Stone Center for Inequality and Shaping the Future of Work. I asked open-ended questions that I hope Stone Center will help answer, centered around the need for a big and strong middle class, into which a college diploma is not the only ticket.

In the future, I do not believe that the diploma divide will be the economy's most meaningful. Instead, the divide will be above or below the API (application programming interface). Workers who make software & hardware augment & amplify them will benefit from above the API. Those below the API, where software & hardware are governing their time & agency, will have much less leverage. As software continues to eat more of the world, to borrow a famous phrase, one goal of policy should be an economy that works like Etsy, that empowers creators above the API, as opposed to TikTok, where most users are below the API.

Better transit for a better business climate: I joined a panel of transit experts at the MIT Mobility Initiative. Here are my takeaways:

• A good metric for urban mobility policy is the number of jobs within a 30-minute commuter shed. Cities are labor markets, and improving the reliability and convenience of transit makes the market work better.

• Request for entrepreneurship: America needs a mass-producible, “Buy America”-compliant bus-manufacturing start-up to disrupt the duopoly that is raising prices everywhere.
  

• The Federal Highway Administration is more of a problem than a solution, by virtue of how much it subsidizes car-centric infrastructure at the expense of transit and walkability. Its functions and funding should be devolved to the states.

Mansfield Food Pantry: More than 70 Mansfield volunteers run and staff the local food pantry every week, helping hundreds of Mansfield families who need help with groceries. I spoke with the dedicated leaders of this operation, which has been helping neighbors since 1997. Look local and you'll always see the common sense and decency of Americans, solving problems and lending a hand. 

Congressional update and Q&A in Millis: The American Legion Post 208 in Millis welcomed me back for another congressional update and Q&A. I discussed my bipartisan bills on Rx drug pricing, fentanyl interdiction, and geothermal energy R&D and permitting reform. The focus is on lowering prices and protecting Americans.

Veterans Day in Milford: On Veterans Day, I was honored to speak in Milford about the United States Armed Forces as defenders of freedom and a model for a divided America. Just as veterans had one another's backs in combat, so must Americans from all walks of life remember that we are in covenant with one another to protect each other's natural rights.

Question: Seeing this office is taking a stance on social media and digital dopamine, what, if anything, is being done to combat the mental health crisis we're currently facing? People are lonelier than ever and are turning to online platforms and even AI chatbots for companionship. Some of these individuals then adopt violent and extremist ideologies, showcased by the Kirk shooter. Make no mistake, I am in favor of gun regulations and additional control, but the sheer level of gun violence we are seeing is a symptom of ever-worsening mental health on a national level, not just the effect of certain gun policies.

 - Liana, Fall River

Answer: I am supporting efforts in at least three domains. First, direct & muscular regulation of the social media corporations, themselves, which have corroded our culture: narrowing their liability shield, establishing standards for their chatbots, and implementing consumer protections for their mining of digital dopamine. Second, America needs more research and better care for mental health. Diseases like schizophrenia are slowly becoming tractable to treatment, but much ground is as yet unplowed in both the science and the care models. I support legislation to better fund and reimburse for mental health R&D and delivery – particularly through Medicaid, which covers much of this patient population but is too hamstrung by federal red tape.

Finally, and perhaps most importantly, American culture itself needs to celebrate community. There is no government-directed fix for widespread loneliness, anger, and sadness – but we can all recognize that being together, IRL, is vital to any person’s wellbeing and resilience. Using my voice and vote, I try to lift up local organizations that bring us together, like our YMCAs, and bring along the lost and the left behind, like Parents for Peace.

You can submit a question for a future newsletter here. Please note that casework inquiries for federal agencies must be submitted to my website here. My casework team will respond to these in a timely manner. 

Have a happy Thanksgiving! 

Jake